The maxillary canine is often impacted during the development of permanent dentition. Knowing the risks of impacted maxillary canines, especially their tendency to dissolve the roots of neighboring teeth, highlights the importance of early detection and intervention to prevent lasting damage [13].
During the incidence of canine impaction, the most important part is determining whether or not root resorption occurred in the adjacent teeth. A number of 4500 panoramic radiographs were obtained from the Radiographic Department at the dental clinics of the College of Dentistry, Qassim University. Our study employed clear participant selection criteria to ensure the validity and generalizability of our findings. One of the inclusion criteria was to involve patients ≥ 12 years old. This age guarantees accurate assessment of impaction and root resorption due to the complete development of permanent teeth at this age. Additionally, excluding patients with specific conditions such as cleft lip and palate, jaw fractures, and prior orthodontic treatment minimized extraneous factors that could potentially influence the degree and incidence of root resorption on adjacent teeth. This meticulous selection process strengthened the internal validity of the study and enhanced the trustworthiness of our conclusions. By carefully selecting participants, we built a reliable foundation for our study, leading to valuable insights and ultimately better diagnosis for impacted canine cases.
Several patients were found with impacted canines (n = 82). The total number of impacted canines was 110 with a prevalence of 2.4%. Different studies reported similar results regarding the incidence of maxillary canine impaction [3, 11]. In the current study, the impacted canines were found to be higher in males (56.1%) than females (43.9%). Although this suggests a potential gender difference, statistical analysis did not reveal a significant association. It has been reported that females showed a higher incidence of impacted canines than males [9, 11]. The disagreement with the results could be an outcome of including more male patients in our study. Interestingly, a significant gender difference emerged when we looked at root resorption. Males with impacted maxillary canines exhibited a higher rate of root resorption compared to females (p = 0.01). Most of the current studies showed a higher incidence of toot resorption in females [8, 9]. Another study showed no relationship between gender and the prevalence of root resorption in cases with impacted maxillary canines [12]. Our higher proportion of male participants might explain this discrepancy. The root resorption can occur in both genders; however, in our sample, males exhibited a higher rate of root resorption than females.
Lateral incisors are in close proximity to canines. In our samples, the most affected teeth were lateral incisors (89.5%). Nagani et al. (2021) evaluated the effect of impacted maxillary canines on the roots of the adjacent teeth. They also found that the lateral incisors were the most affected teeth with root resorption (62.5%) [4]. Another study reported that the maxillary lateral incisors are most commonly affected with root resorption (55.7%) in cases with impacted maxillary canines [8]. This highlights the crucial need to carefully assess lateral incisors for resorption in every case with impacted maxillary canines.
Our study aimed to investigate the relationship between the location of impacted maxillary canines and the degree of root resorption in adjacent teeth. While our findings indicated a higher prevalence of root resorption in sectors 1 and 2 (79%), previous research has presented mixed results. Rafflenbeul et al. (2019) similarly identified sectors 1–3 as hotspots for root resorption with the tendency of lower incidences in sectors 4 and 5 [8]. However, other studies showed that the more severe the displacement, the higher the incidence of root resorption [9, 11]. Despite the inconsistencies, our study underlines the importance of meticulously evaluating all impacted maxillary canines for potential root resorption, regardless of their location, to ensure optimal patient care.
While panoramic radiographs offered a convenient screening tool in our study, they may not always give the full picture. Their two-dimensional limitations highlight the potential for underestimating the true extent of resorption. For more accurate assessment, especially in complex cases, advanced imaging techniques like Cone Beam Computed Tomography (CBCT) can provide detailed three-dimensional views, leading to more reliable results.